Provider Demographics
NPI:1962028951
Name:WALKER, SHERAFAH (FNP)
Entity Type:Individual
Prefix:
First Name:SHERAFAH
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12210 S LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-6823
Mailing Address - Country:US
Mailing Address - Phone:773-469-2404
Mailing Address - Fax:
Practice Address - Street 1:12210 S LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-6823
Practice Address - Country:US
Practice Address - Phone:773-469-2404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily